Controlled anal incontinence disease treatment

ABSTRACT

An anal incontinence disease treatment apparatus and method include and use an operable restriction device implanted in a patient and engaging the colon or engaging the rectum to form a restricted fecal passageway in the colon or rectum. A source of energy for energizing the restriction device is provided, as well as a control device for releasing energy from the source of energy from outside the patient&#39;s body. The released energy is used in connection with the operation of the restriction device, i.e. to enlarge and contract the fecal passageway to allow or substantially prevent passage of fecal material through the passageway.

CROSS REFERENCE TO RELATED APPLICATION

This application incorporates herein by reference the disclosure ofprovisional application Ser. No. 60/148,345, filed Aug. 12, 1999.

BACKGROUND OF THE INVENTION

The present invention relates to an anal incontinence disease treatmentapparatus and method. More specifically, the invention relates to ananal incontinence disease treatment apparatus and method for surgicalapplication in the abdomen of a patient for forming a restricted fecalpassageway in the colon or rectum. The term patient includes an animalor a human being.

Anal incontinence disease is a widespread medical problem. Several kindsof sphincter plastic surgery are used today to remedy anal incontinence.There is a prior manually operated sphincter system in an initialclinical trial phase where a hydraulic sphincter system connected to areservoir placed in the scrotum is developed. A disadvantage of thissystem is that thick, hard fibrosis is created around the reservoir bypump movements making the system useless sooner or later.

U.S. Pat. No. 5,593,443 discloses a hydraulic anal sphincter under bothreflex and voluntary control. A pressure controlled inflatableartificial sphincter is disclosed in U.S. Pat. No. 4,222,377.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide a new convenientanal incontinence disease treatment apparatus, the performance of whichmay be affected by the patient at any time after operation, inparticular when various needs arise over the day, so that the patientalways is satisfied.

Accordingly, there is provided an anal incontinence disease treatmentapparatus, comprising an operable restriction device implanted in apatient and engaging the colon or engaging the rectum to form arestricted fecal passageway in the colon or rectum, a source of energyfor energizing the restriction device, and a control device operablefrom outside the patient's body for releasing energy from the source ofenergy, wherein the released energy is used in connection with theoperation of the restriction device.

As a result, the advantage is achieved that the implanted restrictiondevice can be non-invasively operated, when the restriction device hasto be adjusted. Furthermore, the apparatus of the invention provides asimple and effective control of the energy supplied to implantedcomponents of the apparatus which ensures long reliable function of theapparatus, possibly for the rest of the patient's life.

The restriction device preferably controls the cross-sectional area ofthe fecal passageway in the colon or rectum, which gives the advantagethat the patient is enabled to adjust the cross-sectional area of thefecal passageway whenever he likes during the day. This advantage shouldnot be underestimated, because in case the patient would need to vomitit would be very difficult for him to do so if he were unable toimmediately enlarge the cross-sectional area of the fecal passageway.

The control device may also control the restriction device. The controldevice may comprise an internal control unit, preferably including amicroprocessor, implanted in the patient for controlling the restrictiondevice. The control device may further comprise an external control unitoutside the patient's body, wherein the internal control unit isprogrammable by the external control unit, for example for controllingthe restriction device over time. Alternatively, the internal controlunit may control the restriction device over time in accordance with anactivity schedule program, which may be adapted to the patient's needs.

Conveniently, the external control unit may load the internal controlunit with data in accordance with a loading mode only authorized for adoctor. For specialized controls of the restriction device, the externalcontrol unit may control the internal control unit in accordance with adoctor mode only authorized for the doctor. For simple controls of therestriction device, the external control unit may control the internalcontrol unit in accordance with a patient mode permitted for thepatient. Thus, by using the external control unit in accordance withdifferent modes it is possible to have certain functions of therestriction device controlled by the patient and other more advancedfunctions controlled by the doctor resulting, which enables a flexiblepost-operation treatment of the patient.

Generally, the apparatus further comprises an operation device implantedin the patient for operating the restriction device, wherein the controldevice controls the operation device to operate the restriction device.The control device may directly power the operation device with energyreleased from the source of energy and/or power other implanted energyconsuming components of the apparatus. The term “directly” is used tomean, on one hand, that the operation device is powered with releasedenergy while the latter is being released by the control device, on theother hand, that the released energy may be somewhat delayed, in theorder of seconds, by for instance an energy stabilizer before poweringthe operation device. The advantage of directly using energy as it isreleased is that the apparatus can be of a very simple design and thefew components involved makes the apparatus extremely reliable.

The restriction device may be non-inflatable, i.e. with no hydraulicfluid involved for the adjustments of the restriction device. Thiseliminates problems with fluid leaking from the restriction device.

The operation device may comprise hydraulic means and at least one valvefor controlling a fluid flow in the hydraulic means. The control devicemay suitably comprise a wireless remote control for controlling thevalve. The restriction device may comprise hydraulic means and theoperation device may comprise a reservoir forming a fluid chamber with avariable volume connected to the hydraulic means. The operation devicemay distribute fluid from the chamber to the hydraulic means byreduction of the volume of the chamber and withdraw fluid from thehydraulic means to the chamber by expansion of the volume of thechamber.

In accordance with a first main aspect of the invention, the source ofenergy is external to the patient's body and the control device releaseswireless energy from the source of energy. An energy storage device,preferably an electric accumulator, may be implanted in the patient forstoring the wireless energy released from the external source of energy.The electric accumulator may comprise at least one capacitor or at leastone rechargeable battery, or a combination of at least one capacitor andat least one rechargeable battery. Alternatively, a battery may beimplanted in the patient for supplying electric energy to implantedelectric energy consuming components of the apparatus, in addition tothe supply of wireless energy. Where the control device comprises animplanted control unit the electronic circuit thereof and therestriction device may be directly powered with transformed wirelessenergy, or energy from either the implanted energy storage device orbattery.

In a first particular embodiment in accordance with the first mainaspect of the invention, the operation device comprises a motor,preferably an electric motor which may have electrically conductiveparts made of plastics. The motor may include a rotary motor, whereinthe control device is adapted to control the rotary motor to rotate adesired number of revolutions. Alternatively, the motor may include alinear motor, or a hydraulic or pneumatic fluid motor, wherein thecontrol device is adapted to control the fluid flow through the fluidmotor. Motors currently available on the market are getting smaller andsmaller. Furthermore, there is a great variety of control methods andminiaturized control equipment available. For example, a number ofrevolutions of a rotary motor may be analyzed by a Hall-element just afew mm in size.

In a second particular embodiment in accordance with the first mainaspect of the invention, the control device is adapted to shift polarityof the released energy to reverse the operation device. The operationdevice may suitably comprise an electric motor and the released energymay comprise electric energy.

In a third particular embodiment in accordance with the first mainaspect of the invention, the restriction device is operable to perform areversible function and there is a reversing device implanted in thepatient for reversing the function performed by the restriction device.Such a reversing function preferably involves enlarging and restrictingthe fecal passageway by the restriction device, suitably in a steplessmanner. In this connection, the control device suitably controls thereversing device, which may include a switch, to reverse the functionperformed by the restriction device. The reversing device may comprisehydraulic means including a valve for shifting the flow direction of afluid in the hydraulic means. Alternatively, the reversing device maycomprise a mechanical reversing device, such as a switch or a gear box.

Where the reversing device comprises a switch the control devicesuitably controls the operation of the switch by shifting polarity ofreleased energy supplied to the switch. The switch may comprise anelectric switch and the source of energy may supply electric energy forthe operation of the switch. The switch mentioned above may comprise anelectronic switch or, where applicable, a mechanical switch.

In accordance with the third particular embodiment, the operation devicepreferably comprises a motor, wherein the reversing device reverses themotor.

In a fourth particular embodiment in accordance with the first mainaspect of the invention, the restriction device comprises hydraulicmeans, for example including an expansible/contractible cavity forfluid. The operation device preferably comprises a pump for pumping afluid in the hydraulic means, a motor for driving the pump, a valvelessfluid conduit between the pump and the hydraulic means of therestriction device, and a reservoir for fluid, wherein the reservoirforms part of the conduit. All of the hydraulic components involved arepreferably devoid of any non-return valve. This is of great advantage,because with valves involved there is always a risk of malfunction dueto improperly working valves, especially when long time periods passesbetween valve operations. The reservoir may form a fluid chamber with avariable volume, and the pump may distribute fluid from the chamber tothe hydraulic means of the restriction device by reduction of the volumeof the chamber and withdraw fluid from the hydraulic means to thechamber by expansion of the volume of the chamber.

In accordance with a second main aspect of the invention, the source ofenergy is implanted in the patient. Thus, the control device releasesenergy from the implanted source of energy from outside the patient'sbody. This solution is advantageous for embodiments of the apparatusthat have a relatively high energy consumption which cannot be satisfiedby direct supply of wireless energy.

The source of energy thus implanted may comprise an accumulator,preferably an electric source of energy, such as a battery having alife-time of at least 10 years.

The above first, second, third and fourth particular embodimentsdescribed in connection with the first main aspect of the invention arealso applicable in accordance with the second main aspect of theinvention, i.e. where the source of energy is implanted.

All of the above embodiments may be combined with at least one implantedsensor for sensing at least one physical parameter of the patient,wherein the control device may control the restriction device inresponse to signals from the sensor. For example, the sensor maycomprise a pressure sensor for directly or indirectly sensing thepressure in the fecal passageway. The pressure sensor may be anysuitable known or conventional pressure sensor such as shown in U.S.Pat. Nos. 5,540,731, 4,846,181, 4,738,267, 4,571,749, 4,407,296 or3,939,823; or an NPC-102 Medical Angioplasty Sensor. The expression“indirectly sensing the pressure in the fecal passageway” should beunderstood to encompass the cases where the sensor senses the pressureagainst the restriction device or human tissue of the patient. Where thecontrol device comprises an internal control unit implanted in thepatient, the internal control unit may suitably directly control therestriction device in response to signals from the sensor. In responseto signals from the sensor, for example pressure, the patient's positionor any other important physical parameter, the internal control unit maysend information thereon to outside the patient's body. The control unitmay also automatically control the restriction device in response tosignals from the sensor. For example, the control unit may control therestriction device to further restrict the fecal passageway in the colonin response to the sensor sensing that the patient is lying, or enlargethe fecal passageway in response to the sensor sensing an abnormallyhigh pressure against the restriction device.

Where the control device comprises an external control unit outside thepatient's body, the external control unit may, suitably directly,control the restriction device in response to signals from the sensor.The external control unit may store information on the physicalparameter sensed by the sensor and may be manually operated to controlthe restriction device based on the stored information. In addition,there may be at least one implanted sender for sending information onthe physical parameter sensed by the sensor.

An external data communicator may be provided outside the patient's bodyand an internal data communicator may be implanted in the patient forcommunicating with the external communicator. The implanted communicatormay feed data related to the patient, or related to the implantedrestriction device, back to the external communicator. Alternatively orin combination, the external communicator may feed data to the internalcommunicator. The implanted communicator may suitably feed data relatedto at least one physical signal of the patient.

Generally, the apparatus of the invention may comprise a switchimplanted in the patient for directly or indirectly switching the energyreleased from the source of energy. The restriction device may controlthe cross-sectional area of the fecal passageway. For example, therestriction device may be operable to open and close the fecalpassageway or may steplessly control the cross-sectional area of thefecal passageway. A pressure sensor may be provided for directly orindirectly sensing the pressure in the fecal passageway. The controldevice may control the restriction device in response to signals fromthe pressure sensor.

The apparatus may comprise an implanted energy transfer device, whereinthe control device releases electric energy and the energy transferdevice transfers the electric energy into kinetic energy for, preferablydirect, operation of the restriction device. Suitably, an implantedstabilizer, such as a capacitor or a rechargeable accumulator, or thelike, may be provided for stabilizing the electric energy released bysaid control device. In addition, the control device may release energyfor a determined time period or in a determined number of energy pulses.Finally, the restriction device may be non-inflatable.

All of the above embodiments are preferably remote controlled. Thus, thecontrol device advantageously comprises a wireless remote controltransmitting at least one wireless control signal for controlling therestriction device. With such a remote control it will be possible toadapt the function of the apparatus to the patient's need in a dailybasis, which is beneficial with respect to the treatment of the patient.

The wireless remote control may be capable of obtaining information onthe condition of the implanted restriction device and of controlling therestriction device in response to the information. Also, The remotecontrol may be capable of sending information related to the restrictiondevice from inside the patient's body to the outside thereof.

In a particular embodiment of the invention, the wireless remote controlcomprises at least one external signal transmitter or tranceiver and atleast one internal signal receiver or transciever implanted in thepatient. In another particular embodiment of the invention, the wirelessremote control comprises at least one external signal reciever ortransceiver and at least one internal signal transmitter or transceiverimplanted in the patient.

The remote control may transmit a carrier signal for carrying thecontrol signal, wherein the carrier signal is frequency, amplitude orfrequency and amplitude modulated and is digital, analog or digital andanalog. Also the control signal used with the carrier signal may befrequency, amplitude or frequency and amplitude modulated.

The control signal may comprise a wave signal, for example, a sound wavesignal, such as an ultrasound wave signal, an electromagnetic wavesignal, such as an infrared light signal, a visible light signal, anultra violet light signal, a laser signal, a micro wave signal, a radiowave signal, an x-ray radiation signal, or a gamma radiation signal.Where applicable, two or more of the above signals may be combined.

The control signal may be digital or analog, and may comprise anelectric or magnetic field. Suitably, the wireless remote control maytransmit an electromagnetic carrier wave signal for carrying the digitalor analog control signal. For example, use of an analog carrier wavesignal carrying a digital control signal would give safe communication.The control signal may be transmitted in pulses by the wireless remotecontrol.

In all of the above solutions, the control device advantageouslyreleases energy from the source of energy in a non-invasive, mechanicalor non-mechanical manner.

The control device may release magnetic, electromagnetic, kinetic orthermal energy, or non-magnetic, non-thermal, non-electromagnetic ornon-kinetic energy.

Another object of the present invention is to provide methods fortreating anal incontinence disease.

Accordingly, in accordance with a first alternative there is provided amethod of treating anal incontinence disease, comprising the steps ofimplanting an operable restriction device in a patient engaging thecolon or rectum to form a restricted fecal passageway in the colon orrectum, providing a source of energy for energizing the restrictiondevice, and controlling the source of energy to release energy for usein connection with the operation of the restriction device. The methodmay further comprise using energy released from the source of energy tooperate the restriction device to enlarge and reduce, respectively, thefecal pasageway.

In accordance with a second alternative there is provided a method oftreating anal incontinence disease, comprising the steps of placing atleast two laparascopical trocars in a patient's body, inserting adissecting tool through the trocars and dissecting an area of the colonor rectum, placing an operable restriction device in the dissected area,so that the restriction device engages the colon close to the cardia orengages the rectum to form a restricted fecal passageway in the colon orrectum, implanting a source of energy in the patient, and controllingthe implanted source of energy from outside the patient's body torelease energy for use in connection with the operation of therestriction device.

In accordance with a third alternative there is provided a method oftreating anal incontinence disease, comprising the steps of placing atleast two laparascopical trocars in a patient's body, inserting adissecting tool through the trocars and dissecting an area of the colonor rectum, implanting an operable restriction device in the dissectedarea, so that the restriction device engages the colon rectum to form arestricted fecal passageway in the colon or rectum, implanting an energytransfer device in the patient, providing an external source of energy,controlling the external source of energy to release wireless energy,and transferring the wireless energy by the energy transfer device intoenergy for use in connection with the operation of the restrictiondevice.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1 to 4 are schematic block diagrams illustrating four embodiments,respectively, of the invention, in which wireless energy is releasedfrom an external source of energy;

FIGS. 5 to 8 are schematic block diagrams illustrating four embodiments,respectively, of the invention, in which energy is released from animplanted source of energy;

FIG. 9 is a schematic block diagram illustrating conceivablecombinations of implanted components for achieving various communicationoptions;

FIG. 10 illustrates the apparatus in accordance with the inventionimplanted in a patient;

FIG. 11 is a block diagram illustrating remote control components of anembodiment of the invention; and

FIG. 12 is a schematic view of exemplary circuitry used for thecomponents of the block diagram of FIG. 11.

Referring to the drawing figures, like reference numerals designateidentical or corresponding elements throughout the several figures.

DETAILED DESCRIPTION OF THE DRAWINGS

FIG. 1 schematically shows an embodiment of the anal incontinencedisease apparatus of the invention having some parts implanted in apatient and other parts located outside the patient's body. Thus, inFIG. 1 all parts placed to the right of the patient's skin 2 areimplanted and all parts placed to the left of the skin 2 are locatedoutside the patient's body.

The apparatus of FIG. 1 comprises an implanted operable restrictiondevice 4, which engages the patient's colon (or alternatively engagesthe rectum) to form a restricted fecal passageway in the colon. Therestriction device 4 is capable of performing a reversible function,i.e. to enlarge and reduce the cross-sectional area of the fecalpassageway, whereby the restriction device works as an artificialsphincter. An implanted control unit 6 controls the restriction device 4via a control line 8 to form an adequate size of the cross-section areaof the restricted fecal passageway. An external control unit 10 includesan external source of energy and a wireless remote control transmittinga control signal generated by the external source of energy. The controlsignal is received by a signal receiver incorporated in the implantedcontrol unit 6, whereby the control unit 6 controls the implantedrestriction device 4 in response to the control signal. The implantedcontrol unit 6 also uses energy from the control signal for operatingthe restriction device 4 via a power supply line 12.

FIG. 2 shows an embodiment of the invention identical to that of FIG. 1,except that a reversing device in the form of a switch 14 operable byenergy also is implanted in the patient for reversing the restrictiondevice 4. The control unit 6 uses the switch 14 to reverse the functionperformed by the restriction device 4. More precisely, the externalcontrol unit 10 releases energy carried by a wireless signal and theimplanted control unit 6 transfers the wireless energy into a currentfor operating the switch 14. When the control unit 6 shifts the polarityof the current the switch 14 reverses the function performed by therestriction device 4.

FIG. 3 shows an embodiment of the invention identical to that of FIG. 1,except that an assembly 16 including a motor/pump unit 18 and a fluidreservoir 20 also is implanted in the patient. In this case therestriction device 4 is hydraulically operated, i.e. hydraulic fluid ispumped by the motor/pump unit 18 from the reservoir 20 through a conduit22 to the restriction device 4 to reduce the cross-sectional area of thefecal passageway, and hydraulic fluid is pumped by the motor/pump unit18 back from the restriction device 4 to the reservoir 20 to enlarge thecross-sectional area. The external control unit 10 releases energycarried by a wireless signal and the implanted control unit 6 transfersthe wireless energy into a current, for example a current, for poweringthe motor/pump unit 18 via an electric power supply line 24. Theimplanted control unit 6 controls the motor/pump unit 16 and therestriction device 4 via control lines 26 and 27.

FIG. 4 shows an embodiment of the invention identical to that of FIG. 1,except that an accumulator 28 also is implanted in the patient. Thecontrol unit 6 stores energy received from the external control unit 10in the accumulator 28. In response to a control signal from the externalcontrol unit 10 the implanted control unit 6 releases energy from theaccumulator 28 via a power line 30 for the operation of the restrictiondevice 4.

FIG. 5 shows an embodiment of the invention comprising the restrictiondevice 4, hydraulically operated, and the implanted control unit 6, andfurther comprising a source of energy in the form of a battery 32, ahydraulic fluid reservoir 34, a motor/pump unit 36 and a reversingdevice in the form of a hydraulic valve shifting device 38, all of whichare implanted in the patient. The motor of the motor/pump unit 36 is anelectric motor. An external control unit 40 includes a wireless remotecontrol transmitting a control signal which is received by the signalreceiver incorporated in the implanted control unit 6.

In response to a control signal from the external control unit 40 theimplanted control unit 6 powers the motor/pump unit 36 with energy fromthe battery 32, whereby the motor/pump unit 36 distributes hydraulicfluid between the reservoir 34 and the restriction device 4. The controlunit 6 controls the shifting device 38 to shift the hydraulic fluid flowdirection between one direction in which the fluid is pumped by themotor/pump unit 36 from the reservoir 34 to the restriction device 4 toreduce the cross-sectional area of the fecal passageway, and anotheropposite direction in which the fluid is pumped by the motor/pump unit36 back from the restriction device 4 to the reservoir 34 to enlarge thecross-sectional area.

FIG. 6 shows an embodiment of the invention identical to that of FIG. 4,except that a battery 42 is substituted for the accumulator 28, theexternal control unit 40 of the embodiment of FIG. 5 is substituted forthe external control unit 10 and an electric motor 44 is implanted inthe patient for operating the restriction device 4. In response to acontrol signal from the external control unit 40 the implanted controlunit 6 powers the motor 44 with energy from the battery 42, whereby themotor 44 operates the restriction device 4.

FIG. 7 shows an embodiment of the invention identical to that of FIG. 6,except that the motor/pump unit 36 of the embodiment of FIG. 5 issubstituted for the motor 44 and a fluid reservoir 46 also implanted inthe patient and via fluid conduits 48 and 50 connected to the motor/pumpunit 36 and the restriction device 4, which in this case ishydraulically operated. In response to a control signal from theexternal control unit 40 the implanted control unit 6 powers theelectric motor of the motor/pump unit 36 with energy from the battery42, whereby the motor/pump unit 36 distributes hydraulic fluid betweenthe fluid reservoir 46 and the restriction device 4.

FIG. 8 shows an embodiment of the invention identical to that of FIG. 6,except that a mechanical reversing device in the form of a gear box 52also is implanted in the patient. The implanted control unit 6 controlsthe gear box 52 to reverse the function performed by the restrictiondevice 4 (mechanically operated).

FIG. 9 schematically shows conceivable combinations of implantedcomponents of the apparatus for achieving various communicationpossibilities. Basically, there are the implanted restriction device 4,the implanted control unit 6 and the external control unit 10 includingthe external source of energy and the wireless remote control. Asalready described above the remote control transmits a control signalgenerated by the external source of energy, and the control signal isreceived by a signal receiver incorporated in the implanted control unit6, whereby the control unit 6 controls the implanted restriction device4 in response to the control signal.

A sensor 54 may be implanted in the patient for sensing a physicalparameter of the patient, such as the pressure in the fecal passageway.The control unit 6, or alternatively the external control unit 10, maycontrol the restriction device 4 in response to signalsfrom the sensor54. A tranceiver may be combined with the sensor 54 for sendinginformation on the sensed physical parameter to the external controlunit 10. The wireless remote control of the external control unit 10 maycomprise a signal transmitter or tranceiver and the implanted controlunit 6 may comprise a signal receiver or transciever. Alternatively, thewireless remote control of the external control unit 10 may comprise asignal reciever or transceiver and the implanted control unit 6 maycomprise a signal transmitter or transceiver. The above tranceivers,transmitters and receivers may be used for sending information or datarelated to the restriction device from inside the patient'sbody to theoutside thereof.

The motor 44 may be implanted for operating the restriction device 4 andalso the battery 32 may be implanted for powering the motor 44. Thebattery 32 may be equipped with a tranceiver for sending information onthe charge condition of the battery.

Those skilled in the art will realize that the above various embodimentsaccording to FIGS. 1-9 could be combined in many different ways. Forexample, the energy operated switch 14 could be incorporated in any ofthe embodiments of FIGS. 3,4,6-8, the hydraulic shifting device 38 couldbe incorporated in any of the embodiments of FIGS. 3 and 7, and the gearbox 52 could be incorporated in any of the embodiments of FIGS. 1,4 and6.

FIG. 10 illustrates how any of the above-described embodiments of theanal incontinence disease treatment apparatus of the invention may beimplanted in a patient. Thus, an assembly of the apparatus implanted inthe patient comprises a restriction device 56 engaging the rectum 58,and an operation device 60 for operating the restriction device 56 andan internal control unit 62, which includes a signal receiver, forcontrolling the operation device 60. An external control unit 64includes a signal transmitter for transmitting a control signal to thesignal receiver of the implanted control unit 62. The implanted controlunit 62 is capable of transferring signal energy from the control signalinto electric energy for powering the operation device 60 and forenergizing energy consuming implanted components of the apparatus.

FIG. 11 shows the basic parts of a wireless remote control of theapparatus of the invention including an electric motor 128 for operatinga restriction member, for example of the type illustrated in FIG. 10. Inthis case, the remote control is based on the transmission ofelectromagnetic wave signals, often of high frequencies in the order of100 kHz-1 gHz, through the skin 130 of the patient. In FIG. 11, allparts placed to the left of the skin 130 are located outside thepatient'sbody and all parts placed to the right of the skin 130 areimplanted. Any suitable remote control system may be used.

An external signal transmitting antenna 132 is to be positioned close toa signal receiving antenna 134 implanted close to the skin 130. As analternative, the receiving antenna 134 may be placed for example insidethe abdomen of the patient. The receiving antenna 134 comprises a coil,approximately 1-100 mm, preferably 25 mm in diameter, wound with a verythin wire and tuned with a capacitor to a specific high frequency. Asmall coil is chosen if it is to be implanted under the skin of thepatient and a large coil is chosen if it is to be implanted in theabdomen of the patient. The transmitting antenna 132 comprises a coilhaving about the same size as the coil of the receiving antenna 134 butwound with a thick wire that can handle the larger currents that isnecessary. The coil of the transmitting antenna 132 is tuned to the samespecific high frequency as the coil of the receiving antenna 134.

An external control unit 136 comprises a microprocessor, a highfrequency electromagnetic wave signal generator and a power amplifier.The microprocessor of the control unit 136 is adapted to switch thegenerator on/off and to modulate signals generated by the generator tosend digital information via the power amplifier and the antennas132,134 to an implanted control unit 138. To avoid that accidentalrandom high frequency fields trigger control commands, digital signalcodes are used. A conventional keypad placed on the external controlunit 136 is connected to the microprocessor thereof. The keypad is usedto order the microprocessor to send digital signals to either contractor enlarge the restriction device. The microprocessor starts a commandby applying a high frequency signal on the antenna 132. After a shorttime, when the signal has energized the implanted parts of the controlsystem, commands are sent to contract or enlarge the restriction devicein predefined steps. The commands are sent as digital packets in theform illustrated below.

Start pattern, 8 Command, 8 Count, 8 bits Checksum, 8 bits bits bits

The commands are sent continuously during a rather long time period(e.g. about 30 seconds or more). When a new contract or enlarge step isdesired the Count byte is increased by one to allow the implantedcontrol unit 138 to decode and understand that another step is demandedby the external control unit 136. If any part of the digital packet iserroneous, its content is simply ignored.

Through a line 140, an implanted energizer unit 126 draws energy fromthe high frequency electromagnetic wave signals received by thereceiving antenna 134. The energizer unit 126 stores the energy in apower supply, such as a large capacitor, powers the control unit 138 andpowers the electric motor 128 via a line 142.

The control unit 138 comprises a demodulator and a microprocessor. Thedemodulator demodulates digital signals sent from the external controlunit 136. The microprocessor of the control unit 138 receives thedigital packet, decodes it and, provided that the power supply of theenergizer unit 126 has sufficient energy stored, sends a signal via asignal line 144 to the motor 128 to either contract or enlarge therestriction device depending on the received command code.

Alternatively, the energy stored in the power supply of the energizerunit may only be used for powering a switch, and the energy for poweringthe motor 128 may be obtained from another implanted power source ofrelatively high capacity, for example a battery. In this case the switchis adapted to connect said battery to the control unit 138 in an on modewhen said switch is powered by said power supply and to keep saidbattery disconnected from the control unit in a standby mode when saidswitch is unpowered.

With reference to FIG. 12, the remote control schematically describedabove will now be described in accordance with a more detailedembodiment. The external control unit 136 comprises a microprocessor146, a signal generator 148 and a power amplifier 150 connected thereto.The microprocessor 146 is adapted to switch the signal generator 148on/off and to modulate signals generated by the signal generator 148with digital commands that are sent to implanted components of theapparatus. The power amplifier 150 amplifies the signals and sends themto the external signal transmitting antenna 132. The antenna 132 isconnected in parallel with a capacitor 152 to form a resonant circuittuned to the frequency generated by the signal generator 148.

The implanted signal receiving antenna coil 134 forms together with acapacitor 154 a resonant circuit that is tuned to the same frequency asthe transmitting antenna 132. The signal receiving antenna coil 134induces a current from the received high frequency electromagnetic wavesand a rectifying diode 160 rectifies the induced current, which chargesa storage capacitor 158. A coil 156 connected between the antenna coil134 and the diode 160 prevents the capacitor 158 and the diode 160 fromloading the circuit of the signal receiving antenna 134 at higherfrequencies. Thus, the coil 156 makes it possible to charge thecapacitor 158 and to transmit digital information using amplitudemodulation.

A capacitor 162 and a resistor 164 connected in parallel and a diode 166forms a detector used to detect amplitude modulated digital information.A filter circuit is formed by a resistor 168 connected in series with aresistor 170 connected in series with a capacitor 172 connected inseries with the resistor 168 via ground, and a capacitor 174, oneterminal of which is connected between the resistors 168,170 and theother terminal of which is connected between the diode 166 and thecircuit formed by the capacitor 162 and resistor 164. The filter circuitis used to filter out undesired low and high frequencies. The detectedand filtered signals are fed to an implanted microprocessor 176 thatdecodes the digital information and controls the motor 128 via anH-bridge 178 comprising transistors 180, 182, 184 and 186. The motor 128can be driven in two opposite directions by the H-bridge 178.

The microprocessor 176 also monitors the amount of stored energy in thestorage capacitor 158. Before sending signals to activate the motor 128,the microprocessor 176 checks whether the energy stored in the storagecapacitor 158 is enough. If the stored energy is not enough to performthe requested operation, the microprocessor 176 waits for the receivedsignals to charge the storage capacitor 158 before activating the motor128.

In the practice of the present invention the details of the elongatedrestriction device 4, 56 (such as a band) and the adjustment/operationdevice (which may have electric, hydraulic, or mechanical, etc.actuation) 6, 60 may be as described in copending applications Ser. No.09/133,319, filed Aug. 13, 1998 (Atty Ref: 2333-12), Ser. No.09/133,320, filed Aug. 13, 1998 (Atty Ref: 2333-11) and Ser. No.09/133,322, filed Aug. 13, 1998 (Atty Ref: 2333-13), the disclosures ofwhich are incorporated by reference herein.

The invention also comprises or consists of the foregoing structures andmethod steps, and is to be interpreted as broadly as allowed by theprior art.

What is claimed is:
 1. An anal incontinence disease treatment apparatus,comprising: an operable restriction device adapted to be implanted in apatient to engage the colon or rectum to form a restricted fecalpassageway in the colon or rectum, an implantable internal source ofenergy for supplying energy to be used in connection with the operationof said restriction device, an energy transfer device for transferringwireless energy into an energy form suited for charging said internalsource of energy, a control device operable from outside the patient'sbody to control said energy transfer device to charge said internalsource of energy with transferred wireless energy, and an internalcontrol unit adapted to be implanted in the patient for controlling saidrestriction device, wherein said control device controls said internalcontrol unit.
 2. The apparatus according to claim 1, wherein saidinternal control unit is programmable.
 3. The apparatus according toclaim 2, wherein said control device further comprises an externalcontrol unit outside the patient's body, said internal control unitbeing programmable by said external control unit.
 4. The apparatusaccording to claim 3, wherein said external control unit loads saidinternal control unit with data in accordance with a loading mode onlyauthorized for a doctor.
 5. The apparatus according to claim 3, whereinsaid external control unit controls said internal control unit inaccordance with a doctor mode only authorized for a doctor.
 6. Theapparatus according to claim 3, wherein said external control unitcontrols said internal control unit in accordance with a patient modepermitted for the patient.
 7. The apparatus according to claim 2,wherein said internal control unit is programmable for controlling saidrestriction device over time.
 8. The apparatus according to claim 7,wherein said internal control unit controls said restriction device overtime in accordance with an activity schedule program.
 9. The apparatusaccording to claim 7, wherein said internal control unit comprises amicroprocessor.
 10. The apparatus according to claim 1, wherein saidcontrol device controls said restriction device.
 11. The apparatusaccording to claim 10, further comprising an operation device implantedin the patient for operating said restriction device, wherein saidcontrol device controls said operation device to operate saidrestriction device.
 12. The apparatus according to claim 11, whereinsaid operation device comprises a motor.
 13. The apparatus according toclaim 12, wherein said motor comprises a rotary motor, and said controldevice controls said rotary motor to rotate a desired number ofrevolutions.
 14. The apparatus according to claim 12, wherein said motorcomprises a hydraulic or pneumatic fluid motor, and said control devicecontrols said fluid motor.
 15. The apparatus according to claim 12,wherein said motor comprises a casing of electrically conductiveplastics.
 16. The apparatus according to claim 10, wherein said controldevice releases energy from said implanted source of energy.
 17. Theapparatus according to claim 10, wherein said control device shiftspolarity of said released energy to reverse said operation device. 18.The apparatus according to claim 17, wherein said restriction devicecomprises hydraulic means, and said operation device comprises a pumpfor pumping a fluid in said hydraulic means and a motor for driving saidpump.
 19. The apparatus according to claim 10, wherein said operationdevice comprises an electric motor and said released energy compriseselectric energy.
 20. The apparatus according to claim 1, wherein saidrestriction device is operable to perform a reversible function.
 21. Theapparatus according to claim 20, further comprising a reversing deviceimplanted in the patient for reversing said function performed by saidrestriction device.
 22. The apparatus according to claim 21, whereinsaid control device controls said reversing device to reverse saidfunction performed by said restriction device.
 23. The apparatusaccording to claim 21, wherein said reversing device comprises hydraulicmeans including a valve for shifting the flow direction of a fluid insaid hydraulic means.
 24. The apparatus according to claim 21, whereinsaid reversing device comprises a mechanical reversing device.
 25. Theapparatus according to claim 24, wherein said mechanical reversingdevice comprises a switch.
 26. The apparatus according to claim 24,wherein said mechanical reversing device comprises a gear box.
 27. Theapparatus according to claim 21, wherein said reversing device comprisesa switch.
 28. The apparatus according to claim 27, wherein said switchis operable by energy released from said source of energy.
 29. Theapparatus according to claim 27, wherein said control device controlsthe operation of said switch by shifting polarity of said releasedenergy supplied to said switch.
 30. The apparatus according to claim 27,wherein said switch comprises an electric switch and said source ofenergy supplies electric energy for the operation of said switch. 31.The apparatus according to claim 21, wherein said operation devicecomprises a motor, and said reversing device reverses said motor. 32.The apparatus according to claim 1, wherein said restriction devicecomprises hydraulic means, and said operation device comprises a pumpfor pumping a fluid in said hydraulic means and a motor for driving saidpump.
 33. The apparatus according to claim 32, wherein said operationdevice comprises a fluid conduit between said pump and said hydraulicmeans of said restriction device, and a reservoir for fluid, saidreservoir forming part of said conduit.
 34. The apparatus according toclaim 33, wherein said hydraulic means, pump and conduit are devoid ofany non-return valve.
 35. The apparatus according to claim 33, whereinsaid reservoir forms a fluid chamber with a variable volume, and saidpump distributes fluid from said chamber to said hydraulic means of saidrestriction device by reducing the volume of said chamber and withdrawsfluid from said hydraulic means to said chamber by expanding the volumeof said chamber.
 36. The apparatus according to claim 1, furthercomprising at least one implanted sensor for sensing at least onephysical parameter of the patient.
 37. The apparatus according to claim36, wherein said control device controls said restriction device inresponse to signals from said sensor.
 38. The apparatus according toclaim 37, wherein said control device comprises an internal control unitimplanted in the patient, said internal control unit directlycontrolling said restriction device in response to signals from saidsensor.
 39. The apparatus according to claim 1, further comprising anexternal data communicator outside the patient's body and an internaldata communicator implanted in the patient for communicating with saidexternal communicator, wherein said implanted communicator feeds datarelated to the patient back to said external communicator or saidexternal communicator feeds data to said internal communicator.
 40. Theapparatus according to claim 1, further comprising a switch implanted inthe patient for directly or indirectly switching said energy releasedfrom said source of energy.
 41. The apparatus according to claim 1,wherein said restriction device controls the cross-sectional area ofsaid fecal passageway.
 42. The apparatus according to claim 41, whereinsaid restriction device is operable to open and close said fecalpassageway.
 43. The apparatus according to claim 41, wherein saidrestriction device steplessly controls the cross-sectional area of saidfecal passageway.
 44. The apparatus according to claim 1, furthercomprising a pressure sensor for directly or indirectly sensing thepressure in said fecal passageway.
 45. The apparatus according to claim44, wherein said control device controls said restriction device inresponse to signals from said pressure sensor.
 46. The apparatusaccording to claim 1, wherein said control device controls said internalsource of energy to release electric energy and said energy transferdevice transfers said electric energy into kinetic energy for operationof said restriction device.
 47. The apparatus according to claim 46,wherein said restriction device is directly operated with said kineticenergy, as said energy transfer device transfers said electric energyinto kinetic energy.
 48. The apparatus according to claim 46, furthercomprising an implanted capacitor for stabilizing said electric energyreleased by said control device.
 49. The apparatus according to claim 1,wherein said restriction device is non-inflatable.
 50. The apparatusaccording to claim 1, wherein said control device controls said sourceof energy to release energy for a determined time period.
 51. Theapparatus according to claim 1, wherein said control device controlssaid source of energy to release energy in a determined number of energypulses.
 52. The apparatus according to claim 1, wherein said controldevice comprises a wireless remote control transmitting at least onewireless control signal for controlling said restriction device.
 53. Theapparatus according to claim 52, wherein said wireless remote controlcomprises at least one external signal transmitter or tranceiver and atleast one internal signal receiver or transciever implanted in thepatient.
 54. The apparatus according to claim 52, wherein said wirelessremote control comprises at least one external signal reciever ortransceiver and at least one internal signal transmitter or transceiverimplanted in the patient.
 55. The apparatus according to claim 52,wherein said remote control is capable of sending information related tosaid restriction device from inside the patient'sbody to the outsidethereof.
 56. The apparatus according to claim 55, wherein said remotecontrol controls said restriction device in response to saidinformation.
 57. The apparatus according to claim 52, wherein saidremote control transmits a carrier signal for carrying said controlsignal.
 58. The apparatus according to claim 57, wherein said carriersignal is frequency, amplitude or frequency and amplitude modulated. 59.The apparatus according to claim 57, wherein said carrier signal isdigital, analog or digital and analog.
 60. The apparatus according toclaim 57, wherein said control signal used with said carrier signal isfrequency, amplitude or frequency and amplitude modulated.
 61. Theapparatus according to claim 52, wherein said control signal comprises awave signal comprising one of a sound wave signal including anultrasound wave signal, an electromagnetic wave signal including aninfrared light signal, a visible light signal, an ultra violet lightsignal and a laser light signal, a micro wave signal, a radio wavesignal, an x-ray radiation signal, and a gamma radiation signal.
 62. Theapparatus according to claim 52, wherein said control signal comprisesan electric, magnetic or electric and magnetic field.
 63. The apparatusaccording to claim 52, wherein said control signal is digital, analog ordigital and analog.
 64. The apparatus according to claim 63, whereinsaid remote control transmits an electromagnetic carrier wave signal forcarrying said digital or analog control signal.
 65. The apparatusaccording to claim 52, wherein said control signal is transmitted inpulses by said wireless remote control.
 66. The apparatus according toclaim 1, wherein said control device releases energy from said source ofenergy in a non-invasive manner.
 67. The apparatus according to claim 1,wherein said control device releases magnetic energy.
 68. The apparatusaccording to claim 1, wherein said control device releaseselectromagnetic energy.
 69. The apparatus according to claim 1, whereinsaid control device releases kinetic energy.
 70. The apparatus accordingto claim 1, wherein said control device releases thermal energy.
 71. Theapparatus according to claim 1, wherein said control device releasesenergy from said source of energy in a mechanical manner.
 72. Theapparatus according to claim 1, wherein said control device releasesnon-magnetic energy.
 73. The apparatus according to claim 1, whereinsaid control device releases non-electromagnetic energy.
 74. Theapparatus according to claim 1, wherein said control device releasesnon-kinetic energy.
 75. The apparatus according to claim 1, wherein saidcontrol device releases or non-thermal energy.
 76. The apparatusaccording to claim 1, wherein said control device releases energy fromsaid source of energy in a non-mechanical manner.
 77. The apparatusaccording to claim 1, further comprising a battery implanted in thepatient for supplying electric energy to implanted electric energyconsuming components of the apparatus.
 78. A method of treating analincontinence disease, comprising: implanting in a patient an operablerestriction device engaging the colon or engaging the rectum to form arestricted fecal passageway in the colon or rectum, implanting in thepatient a source of electric energy for energizing the restrictiondevice, transferring wireless energy into electric energy, charging thesource of energy with the electric energy, and controlling the source ofenergy from outside the patient's body to release electric energy foruse in connection with the operation of the restriction device.
 79. Amethod according to claim 78, further comprising using energy releasedfrom the source of energy to operate the restriction device to enlargeand contract, respectively, the fecal pasageway so as to allow, orsubstantially prevent, the passage of fecal material through the fecalpassageway.
 80. A method according to claim 78, further comprisingimplanting a motor for operating the restriction device.
 81. A methodaccording to claim 78, further comprising implanting a pump foroperating the restriction device.
 82. A method of treating analincontinence disease, comprising the steps of: placing at least twolaparoscopical trocars in a patient's body, inserting a dissecting toolthrough the trocars and dissecting an area of the colon or rectum,placing an operable restriction device in the dissected area, so thatthe restriction device engages the colon or rectum to form a restrictedfecal passageway in the colon or rectum, implanting a source of electricenergy in the patient, transferring wireless energy into electricenergy, charging the source of energy with the electric energy, andcontrolling the implanted source of energy from outside the patient'sbody to release electric energy for use in connection with the operationof the restriction device.
 83. A method of treating anal incontinencedisease, comprising the steps of: placing at least two laparoscopicaltrocars in a patient's body, inserting a dissecting tool through thetrocars and dissecting an area of the colon or rectum, implanting anoperable restriction device in the dissected area, so that therestriction device engages the colon or rectum to form a restrictedfecal passageway in the colon or rectum, implanting an energy transferdevice in the patient, providing an external source of energy,controlling the external source of energy to release wireless energy,and transferring the wireless energy by the energy transfer device intoelectric energy for use in connection with the operation of therestriction device.
 84. An anal incontinence disease treatmentapparatus, comprising: an operable restriction device adapted to beimplanted in a patient to engage the colon or rectum to form arestricted fecal passageway in the colon or rectum, a source of energyexternal to the patient's body, a control device operable from outsidethe patient's body for releasing wireless energy from said source ofenergy without the use of permanent magnets, and an energy transferdevice for transferring the released wireless energy into an energy formsuited for use in connection with the operation of said restrictiondevice.
 85. The apparatus according to claim 84, wherein saidrestriction device is non-inflatable.
 86. The apparatus according toclaim 84, wherein said control device releases energy in a determinednumber of energy pulses.
 87. An anal incontinence disease treatmentapparatus, comprising: an operable restriction device adapted to beimplanted in a patient to engage the colon or rectum to form arestricted fecal passageway in the colon or rectum, a source of energy,a control device operable from outside the patient's body for releasingenergy from said source of energy, said released energy being used inconnection with the operation of said restriction device, a switchimplantable in the patient for directly or indirectly switching saidenergy released from said source of energy, and an energy transferdevice for transferring wireless energy into an energy form suited foroperating said switch.
 88. The apparatus according to claim 87, whereinsaid restriction device is non-inflatable.
 89. The apparatus accordingto claim 87, wherein said control device controls said source of energyto release energy in a determined number of energy pulses.
 90. An analincontinence disease treatment apparatus, comprising: an operablerestriction device adapted to be implanted in a patient to engage thecolon or rectum to form a restricted fecal passageway in the colon orrectum, a source of energy external to the patient's body, and a controldevice operable from outside the patient's body for releasing wirelessenergy from said source of energy and transferring said releasedwireless energy into electric energy to be used in connection with theoperation of said restriction device.
 91. The apparatus according toclaim 90, further comprising an operation device implanted in thepatient for operating said restriction device, wherein said controldevice controls said operation device to operate said restrictiondevice.
 92. The apparatus according to claim 91, wherein said operationdevice comprises hydraulic means and at least one valve for controllinga fluid flow in said hydraulic means.
 93. The apparatus according toclaim 92, wherein said control device comprises a wireless remotecontrol for controlling said valve.
 94. The apparatus according to claim91, wherein said restriction device comprises hydraulic means and saidoperation device comprises a reservoir forming a fluid chamber with avariable volume connected to said hydraulic means, and said operationdevice distributes fluid from said chamber to said hydraulic means byreduction of the volume of said chamber and withdraws fluid from saidhydraulic means to said chamber by expansion of the volume of saidchamber.
 95. The apparatus according to claim 91, further comprising anexternal source of energy, wherein said control device controls saidexternal source of energy to release wireless energy.
 96. The apparatusaccording to claim 95, wherein said restriction device compriseshydraulic means and said operation device comprises a pump for pumping afluid in said hydraulic means.
 97. The apparatus according to claim 91,wherein said operation device comprises a motor.
 98. The apparatusaccording to claim 97, wherein said motor comprises a rotary motor, andsaid control device controls said rotary motor to rotate a desirednumber of revolutions.
 99. The apparatus according to claim 97, whereinsaid motor comprises a linear motor.
 100. The apparatus according toclaim 97, wherein said motor comprises a hydraulic or pneumatic fluidmotor, and said control device controls said fluid motor.
 101. Theapparatus according to claim 97, wherein said motor comprises anelectric motor having electrically conductive parts made of plastics.102. The apparatus according to claim 91, wherein said control deviceshifts polarity of said released energy to reverse said operationdevice.
 103. The apparatus according to claim 91, wherein said operationdevice comprises an electric motor and said released energy compriseselectric energy.
 104. The apparatus according to claim 91, wherein saidrestriction device is operable to perform a reversible function. 105.The apparatus according to claim 104, further comprising a reversingdevice implanted in the patient for reversing said function performed bysaid restriction device.
 106. The apparatus according to claim 105,wherein said control device controls said reversing device to reversesaid function performed by said restriction device.
 107. The apparatusaccording to claim 106, wherein said reversing device comprises aswitch.
 108. The apparatus according to claim 107, wherein said switchis operable by said released energy.
 109. The apparatus according toclaim 108, wherein said control device controls the operation of saidswitch by shifting polarity of said released energy supplied to saidswitch.
 110. The apparatus according to claim 107, wherein said switchcomprises an electric switch and said source of energy supplies electricenergy for the operation of said switch.
 111. The apparatus according toclaim 107, wherein said operation device comprises a motor, and saidreversing device reverses said motor.
 112. The apparatus according toclaim 105, wherein said reversing device comprises hydraulic meansincluding a valve for shifting the flow direction of a fluid in saidhydraulic means.
 113. The apparatus according to claim 105, wherein saidreversing device comprises a mechanical reversing device.
 114. Theapparatus according to claim 113, wherein said mechanical reversingdevice comprises a switch.
 115. The apparatus according to claim 113,wherein said reversing device comprises a gear box.
 116. The apparatusaccording to claim 91, wherein said operation device comprises a motorfor driving said pump.
 117. The apparatus according to claim 116,wherein said operation device comprises a fluid conduit between saidpump and said hydraulic means of said restriction device, and areservoir for fluid, said reservoir forming part of said conduit. 118.The apparatus according to claim 117, wherein said hydraulic means, pumpand conduit is devoid of any non-return valve.
 119. The apparatusaccording to claim 118, wherein said reservoir forms a fluid chamberwith a variable volume, and said pump distributes fluid from saidchamber to said hydraulic means of said restriction device by reductionof the volume of said chamber and withdraws fluid from said hydraulicmeans to said chamber by expansion of the volume of said chamber. 120.The apparatus according to claim 91, wherein said control devicedirectly powers said operation device with energy released from saidsource of energy and/or powers other implanted energy consumingcomponents of the apparatus.
 121. The apparatus according to claim 90,wherein said control device releases energy from said source of energyin a non-invasive manner.
 122. The apparatus according to claim 90,wherein said control device releases magnetic energy.
 123. The apparatusaccording to claim 90, wherein said control device releaseselectromagnetic energy.
 124. The apparatus according to claim 90,wherein said control device releases kinetic energy.
 125. The apparatusaccording to claim 90, wherein said control device releases thermalenergy.
 126. The apparatus according to claim 90, wherein said controldevice releases energy from said source of energy in a mechanicalmanner.
 127. The apparatus according to claim 90, wherein said controldevice releases non-magnetic energy.
 128. The apparatus according toclaim 90, wherein said control device releases non-electromagneticenergy.
 129. The apparatus according to claim 90, wherein said controldevice releases non-kinetic energy.
 130. The apparatus according toclaim 90, wherein said control device releases or non-thermal energy.131. The apparatus according to claim 90, wherein said control devicereleases energy from said source of energy in a non-mechanical manner.132. The apparatus according to claim 90, further comprising a motorimplanted in the patient for operating said restriction device.
 133. Theapparatus according to claim 132, wherein said motor mechanicallyoperates said restriction device.
 134. The apparatus according to claim90, further comprising a pump implanted in the patient for operatingsaid restriction device.
 135. The apparatus according to claim 134,wherein said pump hydraulically operates said restriction device. 136.The apparatus according to claim 90, wherein said restriction device isnon-inflatable.
 137. The apparatus according to claim 132, wherein saidcontrol device releases energy in a determined number of energy pulses.138. The apparatus according to claim 95, wherein said internal sourceof energy stores said wireless energy released from said external sourceof energy.
 139. The apparatus according to claim 138, wherein saidinternal source of energy comprises an accumulator.
 140. The apparatusaccording to claim 139, wherein said accumulator comprises an electricaccumulator.
 141. The apparatus according to claim 140, wherein saidelectric accumulator comprises at least one capacitor or at least onerechargeable battery, or a combination of at least one capacitor and atleast one rechargeable battery.
 142. An anal incontinence diseasetreatment apparatus, comprising: an operable restriction device adaptedto be implanted in a patient to engage the colon or rectum to form arestricted fecal passageway in the colon or rectum, a source ofelectrical energy adapted to be implanted in the patient for supplyingelectric energy to be used in connection with the operation of saidrestriction device, a source of energy external to the patient's body, acontrol device operable from outside the patient's body for releasingwireless energy from said external source of energy, and an energytransfer device for transferring the released wireless energy intoelectrical energy for charging said source of electrical energy withsaid electrical energy.
 143. The apparatus according to claim 142,wherein said implanted source of energy comprises at least oneaccumulator, at least one capacitor or at least one rechargeablebattery, or a combination of at least one capacitor and at least onerechargeable battery.
 144. The apparatus according to claim 143, whereinsaid implanted source of energy comprises an electric source of energy.145. The apparatus according to claim 144, wherein said electric sourceof energy comprises an accumulator, or a battery having a life-time ofat least 10 years.
 146. The apparatus according to claim 142, whereinsaid restriction device is non-inflatable.
 147. The apparatus accordingto claim 142, wherein said control device releases energy in adetermined number of energy pulses.
 148. An anal incontinence diseasetreatment apparatus, comprising: an operable restriction device adaptedto be implanted in a patient to engage the colon or rectum to form arestricted fecal passageway in the colon or rectum, a source of energyadapted to be implanted in the patient for supplying energy to be usedin connection with the operation of said restriction device, an energytransfer device for transferring wireless energy into an energy formsuited for charging said source of energy, a control device operablefrom outside the patient's body to control said energy transfer deviceto charge said internal source of energy with transferred wirelessenergy and to control said source of energy to release energy, and atleast one implantable sensor for sensing at least one physical parameterof the patient, wherein said control device comprises an electricalinternal control unit adapted to be implanted in the patient, saidinternal control unit directly controlling said restriction device inresponse to signals from said sensor.
 149. The apparatus according toclaim 148, wherein said control device comprises an external controlunit outside the patient's body, said external control unit controllingsaid restriction device in response to signals from said sensor. 150.The apparatus according to claim 149, wherein said external control unitdirectly controls said restriction device in response to signals by saidsensor.
 151. The apparatus according to claim 149, wherein said externalcontrol unit stores information on said physical parameter sensed bysaid sensor and is manually operated to control said restriction devicebased on said stored information.
 152. The apparatus according to claim148, wherein said restriction device is non-inflatable.
 153. Theapparatus according to claim 148, wherein said control device releasesenergy in a determined number of energy pulses.
 154. The apparatusaccording to claim 148, further comprising at least one implanted senderfor sending information on said physical parameter sensed by saidsensor.
 155. An anal incontinence disease treatment apparatus,comprising: an operable restriction device adapted to be implanted in apatient to engage the colon or rectum to form a restricted fecalpassageway in the colon or rectum, a source of energy adapted to beimplanted in the patient for supplying energy to be used in connectionwith the operation of said restriction device, an energy transfer devicefor transferring wireless energy into an energy form suited for chargingsaid source of energy, a control device operable from outside thepatient's body to control said energy transfer device to charge saidinternal source of energy with transferred wireless energy and tocontrol said source of energy to release energy, and at least oneimplantable sensor for sensing at least one physical parameter of thepatient, wherein said control device comprises a control unit externalto the patient's body and an internal control unit adapted to beimplanted in the patient, said internal control unit communicating withsaid external control unit in response to signals from said sensor. 156.The apparatus according to claim 155, wherein said restriction device isnon-inflatable.
 157. The apparatus according to claim 155, wherein saidcontrol device controls said source of energy to release energy in adetermined number of energy pulses.
 158. An anal incontinence diseasetreatment apparatus, comprising: an operable restriction device adaptedto be implanted in a patient to engage the colon or rectum to form arestricted fecal passageway in the colon or rectum, a source of energyadapted to be implanted in the patient for supplying energy to be usedin connection with the operation of said restriction device, an energytransfer device for transferring wireless energy into an energy formsuited for charging said source of energy, a control device operablefrom outside the patient's body to control said energy transfer deviceto charge said internal source of energy with transferred wirelessenergy, an external data communicator outside the patient's body, and aninternal data communicator implantable in the patient for communicatingwith said external communicator, wherein said internal data communicatorfeeds data related to the patient back to said external datacommunicator, or said external data communicator feeds data to saidinternal data communicator.
 159. The apparatus according to claim 158,wherein said internal data communicator feeds data related to saidimplanted restriction device.
 160. The apparatus according to claim 158,wherein said internal data communicator feeds data related to at leastone physical signal of the patient.
 161. The apparatus according toclaim 158, wherein said restriction device is non-inflatable.
 162. Theapparatus according to claim 158, wherein said control device controlssaid source of energy to release energy in a determined number of energypulses.
 163. An anal incontinence disease treatment apparatus,comprising: an operable restriction device adapted to be implanted in apatient to engage the colon or rectum to form a restricted fecalpassageway in the colon or rectum, a source of energy adapted to beimplanted in the patient for supplying energy to be used in connectionwith the operation of said restriction device, an energy transfer devicefor transferring wireless energy into an energy form suited for chargingsaid source of energy, a control device operable from outside thepatient's body to control said energy transfer device to charge saidsource of energy with transferred wireless energy, wherein said controldevice comprises a wireless remote control transmitting at least onewireless control signal for controlling said restriction device and aninternal control unit adapted to be implanted in the patient forreceiving the wireless control signal.
 164. The apparatus according toclaim 163, wherein said remote control is capable of obtaininginformation on the condition of said implanted restriction device and tocontrol said restriction device in response to said information. 165.The apparatus according to claim 163, wherein said restriction device isnon-inflatable.
 166. The apparatus according to claim 163, wherein saidcontrol device controls said source of energy to release energy in adetermined number of energy pulses.
 167. An anal incontinence diseasetreatment apparatus, comprising: an operable restriction device adaptedto be implanted in a patient to engage the colon or rectum to form arestricted fecal passageway in the colon or rectum, an operation deviceto operate the restriction device, a source of energy, a control deviceoperable from outside the patient's body for releasing wireless energyfrom said source of energy, and an energy transfer device fortransferring said wireless energy into electric energy, wherein saidcontrol device controls said energy transfer device to power saidoperation device and other implantable energy consuming components ofthe apparatus with said electric energy.
 168. The apparatus according toclaim 167 further comprising an implanted capacitor for stabilizing saidelectric energy.
 169. The apparatus according to claim 167, wherein saidcontrol device controls said source of energy to release energy in adetermined number of energy pulses.
 170. The apparatus according toclaim 167, wherein said restriction device is non-inflatable.
 171. Theapparatus according to claim 167, further comprising a coil implantablein the patient for transforming said wireless energy into a current.172. A method of treating anal incontinence disease, comprising thesteps of: placing at least two laparoscopical trocars in a patient'sbody, inserting a dissecting tool through the trocars and dissecting anarea of the colon or rectum, placing an operable restriction device inthe dissected area, so that the restriction device engages the colon orrectum to form a restricted fecal passageway in the colon or rectum,providing a source of energy, implanting a control unit controlling therestriction device, and controlling the source of energy from outsidethe patient's body using wireless energy that is transferred intoelectric energy from the energy source for use in connection with theoperation of the restriction device.
 173. A method according to claim172, further comprising implanting a motor for operating the restrictiondevice.
 174. A method according to claim 172, further comprisingcontrolling the source of energy to release electric energy for poweringthe motor.
 175. A method according to claim 172, further comprisingimplanting a pump for operating the restriction device.
 176. A method oftreating anal incontinence disease, comprising the steps of: placing atleast two laparoscopical trocars in a patient's body, inserting adissecting tool through the trocars and dissecting an area of the colonor rectum, implanting an operable restriction device in the dissectedarea, so that the restriction device engages the colon or rectum to forma restricted fecal passageway in the colon or rectum, providing anexternal source of energy, providing a control device, using the controldevice to control the external source of energy to release wirelessenergy, implanting an energy transfer device, and using the controldevice to control the energy transfer device to transfer the releasedwireless energy into electric energy for use in connection with theoperation of the restriction device.
 177. A method according to claim176, further comprising sensing at least one physical parameter of thepatient.
 178. A method according to claim 177, further comprising usingthe control device to control the restriction device in response to thesensed physical parameter.